The association between obesity and development of breast cancer is partly due to increased
serum levels of estradiol produced by adipocytes, but the role of insulin resistance and
inflammation associated with obesity is widely discussed.

Reduced physical activity is one factor likely to weight gain in women after adjuvant
chemotherapy for localized breast cancer. Furthermore, physical activity appropriately could
improve many prognostic factors and survival of women after breast cancer. Thus, several
large cohort studies of women with breast cancer showed an average mortality reduction of
45% associated with moderate physical activity compared with inactivity. Adapted Physical
Activity (APA) could also improve fitness, quality of life, body image, treatment compliance
and reduce fatigue.

A rich fruits and vegetables diet combined with regular physical activity appears to offer
the best protection from breast cancer. The nature, frequency, duration, intensity and
arrangement of physical training program meetings are key elements to consider, metabolic
responses differ according to these factors.

The optimal management for an improved level of physical activity appear to be an individual
of at least three sessions per week, 30 to 60 minutes each with a moderate intensity,
allowing a physiological response to chronic exercise and an adequate recovery.

After diagnosis of breast cancer, there is thus many possible risk factors of mortality or
morbidity related to nutritional factors available to management. These risks prevention
through management of these patients appears indispensable through an APA program.

Thus, the investigators propose to test the feasibility of implementing a program of dietary
intervention and APA to prevent the risk of weight gain (which affects more than half of
patients) and maintain and/or increase their level of physical activity during and after
adjuvant chemotherapy.

Inclusion Criteria:

- Female, 18 years ≤ age < 75 years

- With an invasive, non-metastatic, histologically confirmed, first breast carcinoma

- Requiring the prescription of a first line of adjuvant chemotherapy

- Followed in the research center

- Whose ability to participate in the APA intervention has been certified by a medical
certificate issued by physician, the referring physician or the physician
investigator

- Residing within a radius of 60 km around the center investigator or agreeing to bear
the travel costs beyond proposed reimbursement

- Availability and willingness to invest in the PASAPAS study during the program (6
months) and during the post-program follow-up (6 months)

- Able to understand, read and write French

- Covered by a medical insurance

- Written, signed informed consent

Exclusion Criteria:

- Female with metastatic or inflammatory breast cancer,

- History or concomitant primary cancer (except for carcinoma in situ of the uterine
cervix and/or skin basal cell carcinoma and or colon carcinoma in situ and/or not a
breast cancer in complete response for at least 5 years)

- Cons-indication to physical activity practice, at discretion of the investigator,

- In a state of severe malnutrition according to the criteria of the High Authority for
Health (HAS) 2010, namely:

Type of Study:

Study Design:

Outcome Measure:

Assessment in a cohort of adult patients with a 1st breast cancer non-metastatic, the feasibility of implementing an APA intervention during 6 months, in addition to a dietary management, concomitant to prescription of a first-line adjuvant chemotherapy

Outcome Description:

Proportion of patients who participate in at least two mandatory APA sessions by week during all the APA program, except during the 1st week of each course of CT

Completion Date:

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